§ 3.19 p.m.
§ Mr. Bing (Hornchurch)
I beg to move, in page 1, line 6, to leave out "of framing rules."
I have to apologise for the absence of the hon. Member for North Islington (Dr. Guest) who is one of the backers of this Bill and has asked me to express to the House his great regret that he is not here himself to put his point of view.
Perhaps it might be convenient to deal also with the following Amendments: In page 1, leave out lines 13 to 19; and page 2, line 28, leave out from beginning, to "by," in line 29, and insert "the manner approved." These three Amendments fall together, and deal with the question as to whether or not one should proceed by means of rules or by means of exercising powers.
§ Mr. Peter Thorneycroft (Monmouth)
Perhaps it might assist the hon. Member for Hornchurch (Mr. Bing) if I said that as far as the principle is concerned I am prepared to accept it and I am prepared to accept the first and third of the Amendments which it is proposed to take together. I wanted to resist the middle Amendment, for reasons not connected with the principle the hon. Member has in mind.
§ Mr. Bing
It may be for the convenience of the House if I put the point of view I have on this matter, because the hon. Member for Monmouth (Mr. P. Thorneycroft) and I have the Ministry to deal with and, although we may reach agreement, we may not convince the Ministry with regard to the points we have in mind. The difficulty which the hon. Member for Monmouth is in is that midwives, like lawyers, are qualified in two ways. First, like solicitors, they obtain a certificate to practise but, obviously, not all midwives, nor all solicitors, who possess a certificate to practise actually indulge in practice. When he had to decide which midwives must be trained in analgesia the hon. Member had to devise some means to enforce this point of view, not on all midwives, but only on those who came forward to practise.
The method he chose was to take Section 10 of the 1902 Act, and to say that for any midwife who came forward and applied for a certificate under that Act, rules must be framed in such a way by the Central Midwives Board as would 1735 ensure that the midwife in this connection was possessed of the qualifications which enabled her to practise. This is a matter on which perhaps the Parliamentary Secretary for the Ministry of Health can help us later on. The difficulty is that it is not possible for the Midwives Board to frame rules which will bind the local authorities in the way in which they are to deal with the people who come forward and offer themselves as midwives. We propose by this Amendment simply to remove the words, "of framing rules."
The difficulty I am in, and I hope the hon. Member for Monmouth will deal with this matter later in the Debate, is that, once we have removed from the Bill the reference to the rules, it is impossible to leave in a Clause in which we say,Any rules framed by the Board and approved by the Minister for the purpose of subsection (1).I do not know whether the hon. Member wishes to interrupt and deal with the point at this stage. At the moment I cannot see how, if one accepts one Amendment, one can depart from that and insist on leaving in subsection (2). That seem a quite illogical approach.
The third point concerns Clause 3. When we reach that Clause there will be other Amendments to be moved, but the effect which the Amendment which I am discussing has on that Clause consists in leaving out from the beginning of line 28 to "by," in line 29, and of inserting "the manner approved." That would make the Clause read:Any certified midwife who has received instruction in the manner approved by the Board in the administration of analgesia to women in childbirth shall be entitled to administer analgesia.…Then we intend to propose a further Amendment which I should perhaps mention. It is consequential on the other one. I refer to the Amendment in page 2, line 31, to leave out from "accordance," to the end of line 33, and to insert "therewith."
If these Amendments are not made we shall be put in a grave difficulty in connection with Clause 3 because the rules are continually varied and if a midwife has been trained in accordance with the rules of 1906 she might be entitled, as the matter stands, to administer analgesia by quite a different method. That is not what the hon. Member sought to 1736 achieve. He sought to achieve that a midwife should be entitled to administer analgesia in accordance with the method in which she had been trained. No one wishes to allow a midwife, because she has received one course of training, to administer analgesia for a purpose for which she has not been trained. I hope that what we propose will be a comparatively simple method of getting over that very real difficulty. The Clause will then read:Any certified midwife who has received instruction in the manner approved by the Board in the administration of analgesia to women in childbirth is entitled to administer analgesia in accordance therewith.That is, she is entitled only to administer analgesia in accordance with the training which she has received and not in accordance with some rules which may have been subsequently passed but in accordance with which she has not been trained.
I am sorry to take a little time, but this is a matter of some importance. If we are writing into the law—there may be a good reason or there may not be a good reason for doing it—authority for someone to administer analgesia to someone else, it is important that we should make quite certain that we do not give them authority to do something for which they are entirely untrained. The difficulty about this Bill, and I do not blame the hon. Member for it, is that there have been so many hands in it and so many alterations, that there are left in the Bill vestigial phrases which previously referred to various matters, and which now, by merely being left in, are linked with matters with which they are in no way connected. I hope that the House will accept the Amendment and that the Parliamentary Secretary will have a look at these points and do his utmost to accept the Amendment.
§ Mrs. Jean Mann (Coatbridge)
I beg to second the Amendment.
I think and hope that the hon. Member for Monmouth (Mr. P. Thorneycroft) can easily accept this Amendment. We have already discussed this upstairs, but we still seem to carry the weakness in regard to the framing of rules and training in analgesia. The whole field of analgesia is changing; in fact, the whole field, even at the moment is not very static or confined to one particular type, although I believe the Board is training 1737 midwives in one particular type. Very soon, there may be agreement that the particular analgesic which is in use at the moment can be superseded, and there have been a great many complaints about types in which midwives are being trained now. I have had a good number of letters about the ineffectiveness of many courses.
It would be altogether wrong to allow midwives who have had this training to start on something else which may be more intricate and may be fraught with danger to their patients. As research is still going on in newer methods, and particularly in that of trilene, it would be dangerous to allow this Clause to go through without our Amendment. I think the promoters of the Bill are already aware of the much greater advantages of trilene, and know the dangers to patients who are under the care of a midwife who has not had a professional training like a doctor and who does not know whether a patient may be subject to high blood pressure. There is a real danger in such a case in permitting her to use any method of analgesia if she has only been trained in one particular method. I think the hon. Member for Monmouth probably sees the difficulty and agrees with me, and I hope he will agree to the Amendment.
§ Mr. P. Thorneycroft
I think it might shorten our discussion if I say that I am prepared to accept the first Amendment—page 1, line 6. I am obliged to the hon. Members opposite for putting it forward, and I think it is an improvement to the Clause and that it merely widens the powers of the Central Midwives Board. I am also prepared to accept the last Amendment, that to Clause 3, page 2, line 28, so that I hope we need not discuss these matters further.
In regard to the other Amendment, there is a short point to put to the hon. Gentleman opposite. The purposes of subsection (2) is to make provision for a very small class of older midwives whom it may not be possible to train or who perhaps could not qualify. It was felt that they should not be thrown completely out of work, but that they should be reduced to an absolute minimum who would act in few cases, particularly in the remote parts of Scotland, where some of these midwives have brought hundreds 1738 of children into the world. It was felt that we should not rule out all these people. We made provision for exemption in these cases, and that was a suggestion of one of the hon. Ladies opposite, and I put it in on the advice of the Ministry, the Central Midwives Board and the Royal College of Midwives. I hope that, in these circumstances, since I am accepting the first and third Amendments, the hon. Gentleman will not see fit to press the middle one.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)
I think it will be useful if I say a word or two now. First of all, on the point raised by the hon. Member for Monmouth (Mr. P. Thorneycroft), it is true that the Ministry did feel that, if we were to go on the procedure laid down in the original draft, it would have been necessary to have the subsection included, but, with wider powers now granted to the Minister to extend the period of operation of the training, it is not so necessary as it was before.
§ Mr. Thorneycroft
If the hon. Gentleman assures me that is so, I will, of course, take the advice of the Ministry on the subject and accept all three Amendments, which will speed up the matter still more.
§ Mr. Blenkinsop
I think this illustrates the difficulty we are in when dealing with this truncated Bill, because it makes all the clearer the impossibility of dealing with it on its present footing. It is perfectly true, for example with reference to this first Amendment, that if we were to leave in the framing of rules it would obviously place the Board in a very difficult position, as has been made clear, because, first of all, under the requirements of the Midwives Act, 1902, dealing with midwives being trained for the first time, it lays down thatthe duties and powers of the Board shall be as follows:—To frame rulesThat deals purely with those midwives.
- (a) regulating their own proceedings;
- (b) regulating the issue of certificates and the conditions of admission to the roll of Midwives;
- (c) regulating the course of training and the conduct of examinations, and the remuneration of the examiners."
§ Mr. Thorneycroft
I feel that, as I have said that the case for this Amendment was put very clearly by the hon. 1739 Member for Hornchurch (Mr. Bing), and that I will, on the advice of the Parliamentary Secretary, be glad to accept all three Amendments, and as the Minister knows the position with regard to time as well as I do, it is unnecessary for him to repeat all the arguments again.
§ Mr. Blenkinsop
The hon. Member who is himself insisting on going forward with this Bill, which bears so little relation to the Bill that originally came before the House, must give the House the opportunity of considering the completely different position in which we are placed. Unless we have the opportunity of considering the Amendments put forward, it will be quite impossible for the House to reach any decision on them.
§ Mr. McCorquodale (Epsom)
I should like to place on record our entire disapproval of a Member of the Government trying to waste time in this way.
§ Mr. Sydney Silverman (Nelson and Colne)
On a point of Order. I would like to know, Mr. Speaker, for the guidance of hon. Members on future occasions, whether it is in Order for an hon. Member to intervene during a speech by another hon. Member—which has called for no remark from you—to say that the speech is merely being made for the sake of wasting time. To my mind, that is a suggestion of irrelevance and one which is not merely out of Order, but which is also a reflection on the Chair.
§ Mr. Speaker
It is not a matter for me. If the right hon. Gentleman interrupts, it is his responsibility. If he chooses to say that the Minister is wasting time, one knows that that is not out of Order.
§ Mr. Blenkinsop
My point is that it is only right that hon. Members who are being asked to consider this Bill on the Report stage should be given the opportunity of doing so. I see no reason why we should not be fully conversant with the facts of the matter.
I have referred to the position of midwives who have come before the Board for training prior to the coming into force of this Bill. Under the Midwives Act, 1740 1936, as has been made clear, the power is laid down that the Board may frame rules under Section 3 of the principal Actrequiring midwives to attend from time to time, in accordance with the provisions of the rules, a course of instruction approved by the Board.But that also lays down thatEvery authority shall provide or arrange for the provision of such courses of instruction for midwives practising in its area as may be necessary to enable those midwives to comply with the rules under subsection (1) of this section.That means that it should be the duty of the local authority to provide the instruction, and, indeed, raises the question of whether that would not, in fact, make a charge upon the Exchequer which is expressly excluded by a later Clause in this Bill.
Therefore, from that point of view it would be reasonable to accept this Amendment, but I suggest that if this Amendment is accepted, then indeed it weakens the whole powers of this Clause and makes one want to know precisely what the promoters expect to obtain from the Clause itself. Before taking the matter further, one would wish to hear from the promoters precisely what they think can be achieved by the Clause as amended which cannot be achieved in the existing circumstances. That is something which the House ought to have before it is called upon to reach a decision on this or subsequent Amendments.
§ Amendment agreed to.
§ Mr. Bing
I beg to move, in page 1, to leave out lines 13 to 19.
Like the hon. Member for Monmouth (Mr. P. Thorneycroft), I want to get on. I quite appreciate his views, with his eye on the clock, but I think we ought to have some indication of whether it is desired to retain this Clause or not. I have dealt with this matter generally before, and I do not wish to detain the House except to say that once we have accepted the removal of the rules I cannot possibly see how there can be any legal framework upon which this Clause can hang.
§ Mr. S. Silverman
I want to protest against the way in which the House is being treated in the handling of these Amendments. I understand from an interjection made by the hon. Member for Monmouth (Mr. P. Thorneycroft) that he proposes to accept this Amendment. He appears to think that because an Amendment has been moved on one side of the House and accepted by the promoters on the other side, that disposes of the matter and that any further speeches, explanation or argument are a waste of time. There are other Members in the House who have a duty and a responsibility to discharge besides my hon. Friends who moved and seconded this Amendment and the hon. Member for Monmouth.
Before I cast a vote or indicate an opinion when the collection of voices is taken, I should like to know a great deal more about what we are doing. If I understand the argument of my hon. Friend the Member for Hornchurch (Mr. Bing) correctly, it is that the adoption of the Amendment would have the result of making the whole of Clause 1 entirely purposeless, so that it achieves little or nothing. If that is so, I should like to know, before we part with the matter, whether the next Amendment is going to be a proposal to delete Clause 1 altogether, and whether the hon. Member for Monmouth will then accept that, and if he does so what purpose there will be in proceeding with the matter at all.
We have not all been on the Standing Committee, and I think the House is entitled to know what is going on. We are entitled to have proper explanations of what is proposed, and we should not be asked to act as a kind of rubber stamp merely because an Amendment has been moved on one side and has been accepted on the other. Personally, I do not know anything at all about this Amendment; I do not know what the effect of it is on the Clause, or what the effect of the Clause so amended would be on the Bill. Until the matter is properly explained the House has no right to dispose of it.
§ 3.45 p.m.
§ Mr. Blenkinsop
I ask the hon. Member for Monmouth (Mr. P. Thorneycroft) to give some explanation of his views 1742 on the value of this Clause after this Amendment has been made. I think it is only right that we should insist that we ought to know from the promoters of the Bill what they feel can be done under the Clause after these Amendments have been carried. I think the House has a right to that.
§ Mr. Thorneycroft
We all agreed that the discussion on the three Amendments should be taken together. That has taken place and I do not think anything further need be said.
§ Mr. Pargiter (Spelthorne)
I should like to know whether we cannot have an explanation. It is perfectly reasonable that we should have an explanation purely in the interest of the Bill. It seems to me obvious that this Bill cannot go through today. Without an explanation one has no option but to vote against the Amendment. Only one vote, one Division, and the Bill has gone for today. It would be better to have a reasoned explanation of what is intended, as hon. Gentlemen have asked, rather than that we should be in the position of having to divide because we do not know what the Amendment does.
§ Mr. Scholefield Allen (Crewe)
As one who was not a Member of the Standing Committee, I should like to add my protest to that of my hon. Friend the Member for Spelthorne (Mr. Pargiter). I came here at a great deal of inconvenience in order to make up my mind on this issue. If we are not to have explanations, and if the matter is to be dealt with by nodding from one side of the House to the other, how can any hon. Member who has not been a member of the Committee make up his mind as to the attitude to adopt? I find myself quite unable to appreciate what I am being asked to do on this occasion.
§ Mr. Thorneycroft
I am most anxious not to seem discourteous in any way, but the reason was quite clearly given by the Parliamentary Secretary. The original subsection was asked for by the Ministry and the Central Midwives Board, but in their opinion it is no longer necessary owing to the wide powers of postponement given in subsection (3).
§ Amendment agreed to.